Regulating entrepreneurial behaviour in European health care systems

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Author: European Observatory on Health Systems and Policies Series

Date of publication: 2002

Summary: ..."Policy-makers often find themselves torn between two seemingly contradictory health sector objectives. On the one hand, shifting demography and improving technology generate strong interest in permitting innovative new procedures that can improve the ability of service providers to respond to the needs of patients. On the other hand, insufficiently tested interventions and inadequately thought-through schemes run the risk of damaging patients’ health and perhaps even their chances of survival. Faced with this conflict, many policy-makers feel that the only responsible path is to adopt a strong regulatory regime. Confronted by the unknown in the form of unleashed entrepreneurialism, they prefer the known consequences of static, often bureaucratic models of service design and delivery.

Yet the art of regulating well, as this volume contends, is to develop regulatory strategies and frameworks that pursue a middle path, by allowing the carefully controlled introduction of innovative approaches without surrendering major responsibility for achieving good overall outcomes for patients. It is in this balance, in understanding regulation as a means rather than an end, that the way forward must lie. By developing these new regulatory approaches, and by working with countries as they adapt these methods to their own unique health sector circumstances, international organizations can ensure that policy combines the necessary dynamism that entrepreneurialism brings with the essential stability that good public health policy requires.

Ultimately, regulation should be understood as a major instrument in the pursuit of effective stewardship. For governments to successfully manage their health care systems in the public interest, their regulatory initiatives must accommodate a range of innovative as well as traditional objectives, and facilitate the introduction of new as well as the operation of existing activities. This fusion of regulation with entrepreneurialism, then, can serve an important role in the development of effective stewardship of the health sector. It is towards this goal that this volume makes a valuable contribution"... (Marc Danzon, WHO Regional Director for Europe)